Elizabeth C Brackett, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23476 Issued in MN

Practice address

5100 Gamble Dr Suite 100
Mail Stop 31200a Helathpartners West Clinic
Saint Louis Park, MN 55416-1582

Phone

(952) 541-2500

Fax

(952) 541-2539

NPI assigned

Mar 2, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1528035102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-5375",
            "fax_number": "952-595-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 GAMBLE DR SUITE 100",
            "address_2": "MAIL STOP 31200A HELATHPARTNERS WEST CLINIC",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554161582",
            "telephone_number": "952-541-2500",
            "fax_number": "952-541-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "ELIZABETH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "23476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52978000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith Rose Boylan, MD
• Katelyn Boys
• Maisa Boyte, LICSW
• Jessica Mae Brabender, APRN, CPNP
• Stephanie Anne Brace, MA, LMFT
• Signe Bradee, LAMFT
• Jane Ellen Bradley, CNM
• Renea A Bradley, APRN, CNS
• Danielle Brady, PHARM.D.
• Katelyn A Brady, OTRL

• Family Medicine Physician in Saint Louis Park, MN
• Providers in Saint Louis Park, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.